A 67-Year-Old Man with Interstitial Lung Disease, Fever, and Myalgias

A 67-year-old man with a history of interstitial lung disease, previously diagnosed Covid-19 pneumonia, and immunosuppressive therapy was admitted with fever, myalgias, and vomiting. Despite prior treatments including prednisone and mycophenolate mofetil, respiratory symptoms persisted and worsened. Upon presentation, he showed signs of pancytopenia, elevated liver enzymes, and a negative infectious workup. Imaging revealed features consistent with usual interstitial pneumonia and a new paraesophageal lymph node. Ultimately, a diagnosis of human granulocytic anaplasmosis was confirmed via nucleic acid amplification testing, and the patient responded well to doxycycline, later undergoing bilateral lung transplantation.

A 67-year-old man with a history of interstitial lung disease, previously diagnosed Covid-19 pneumonia, and immunosuppressive therapy was admitted with fever, myalgias, and vomiting. Despite prior treatments including prednisone and mycophenolate mofetil, respiratory symptoms persisted and worsened. Upon presentation, he showed signs of pancytopenia, elevated liver enzymes, and a negative infectious workup. Imaging revealed features consistent with usual interstitial pneumonia and a new paraesophageal lymph node. Ultimately, a diagnosis of human granulocytic anaplasmosis was confirmed via nucleic acid amplification testing, and the patient responded well to doxycycline, later undergoing bilateral lung transplantation.